Crescent Light Counseling, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CRESCENT LIGHT COUNSELING, LCSW, PLLC

Practice address

646 Main St Ste 102
Port Jefferson, NY 11777-2230

Phone

(631) 772-9395

NPI assigned

Mar 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Taylor Schultz, LCSW

Title

Manager/Owner

Phone

(631) 617-3696

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1275280620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 MAIN ST STE 102",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772230",
            "telephone_number": "631-772-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 MAIN ST STE 102",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772230",
            "telephone_number": "631-772-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT LIGHT COUNSELING, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-06",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "631-617-3696",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann L Covitz, MSW
• Michelle Marilyn Craddock, ANP
• Benjamin Craig
• Nicholas Peter Craig, M.D.
• Lauren Crean, RN
• Jennifer Crimmins, MSED
• Critical Health Care Registered Nursing Services, PC
• Ann Marie Csorny, LCSW-R
• CVS Albany LLC
• Suzanne D'Addona, LMSW

• Clinical Social Worker in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.